Provider Demographics
NPI:1457502742
Name:HUFFORD, MARCIA LUELLA (RPH)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:LUELLA
Last Name:HUFFORD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:HONSBERGER
Other - Last Name:HUFFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:145 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CRESTLINE
Mailing Address - State:OH
Mailing Address - Zip Code:44827-1430
Mailing Address - Country:US
Mailing Address - Phone:419-683-2512
Mailing Address - Fax:419-683-6322
Practice Address - Street 1:145 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CRESTLINE
Practice Address - State:OH
Practice Address - Zip Code:44827-1430
Practice Address - Country:US
Practice Address - Phone:419-683-2512
Practice Address - Fax:419-683-6322
Is Sole Proprietor?:No
Enumeration Date:2008-10-04
Last Update Date:2008-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03217884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist